Psychological investigation of genital herpes recurrence: prospective assessment and cognitive-behavioral intervention for a chronic physical disorder

Previous studies suggest that anxiety and/or depressed mood are associated with recurrence of genital herpes lesions. The present study sought to extend the assessment of factors associated with genital herpes and to investigate the impact of psychological therapy on features of the disorder. Sixteen genital herpes patients received 5 weeks of either structured discussion or cognitive restructuring (CR) therapy in a group format. Measures of attitude about herpes, global coping, distress, loneliness, health locus of control, and recurrence frequency were administered at pretreatment, posttreatment, and 3 months follow-up. Patients also made daily reports during the 5 weeks of treatment from which information was extracted regarding their herpes symptoms, dysphoria, anxiety, and ongoing coping process. Therapy did not produce the expected reductions in reported distress or loneliness. The CR procedure, however, was associated with reduced frequency of lesion recurrence at follow-up. Avoidant coping was associated with lower recurrence rates, and loneliness scores were associated with higher recurrence rates. Prospective data indicated that recurrences were preceded by elevated anxiety that was independent of prodromal symptoms. These results provide support for the general proposals that psychological factors influence health status and that psychological intervention may reduce disease recurrence.     

The relationship among genital herpes simplex virus, stress, and social support

Despite widespread popular belief in the activation of recurrent lesions in genital herpes simplex virus (HSV) by psychosocial stress, little empirical evidence supports that contention. This study retrospectively examined the role of stress in activation of HSV lesions as mediated by social support. Participants were 59 volunteers who had self-reported culture-positive genital HSV for at least 10 months. Measures of stress proneness (State-Trait Anxiety Inventory; STAI-Trait), recent stressful events (Schedule of Recent Events; SRE), and subjective appraisal of stress (global self-rating) were administered along with measures of general social support and herpes-specific social support. When retrospective reports of HSV symptoms were examined using a multiple-regression approach, duration of disease and amount of herpes-specific social support were found to be significant moderators of the relation between stress and number of HSV recurrences in the preceding 12 months. When duration of disease was short (less than 4 years), stress (SRE) and number of recurrences were positively associated; when disease duration was longer, there was no relationship. Similarly, at low levels of herpes-specific social support, a positive relation between stress (SRE) and number of recurrences was found. However, at higher levels of herpes-specific social support, no association was found. No relation was found between stress proneness (STAI-Trait) and HSV symptoms. However, subjective appraisal (global rating) of stress in the preceding 12 months was positively and significantly correlated with reported number of recurrences. Results are discussed in terms of their clinical implications.     

Smoking, caffeine, and stress: effects on blood pressure and heart rate in male and female college students

This study examined the independent and joint effects of cigarette smoking and caffeine consumption on blood pressure (BP) and heart rate (HR) reactions to stress in male and female college students. Following an initial physiological baseline, participants received one of four experimental treatments (paced smoking, caffeine, smoking plus caffeine, or neither) and had BP and HR measured before, during, and after two stressful tasks. The results revealed that, compared with the control condition, caffeine ingestion enhanced the magnitude of stress-induced systolic BP and HR reactions. Smoking combined additively with stress, and the joint effect of smoking and caffeine was no greater than either taken alone. Males and females were generally similar in their BP and HR responses to smoking, caffeine, and stress. Inconsistencies with previous research and possible physiological mechanisms underlying the observed effects are discussed.     

Analogical transfer, problem similarity, and expertise

When we encounter a new problem, we are often reminded of similar problems solved earlier and may use the solution procedure from an old problem to solve a new one. Such analogical transfer, however, has been difficult to demonstrate empirically, even within a single experimental session. This article proposes a framework for conceptualizing analogical problem solving that can account for the conflicting findings in the literature. In addition, the framework leads to two predictions concerning the transfer behavior of experts and novices. These predictions concern both positive and negative transfer and are based on the different types of features included in the problem representations of experts and novices. First, when two problems share structural features but not surface features, spontaneous positive transfer should be more likely in experts than in novices. Second, when two problems share surface but not structural features, spontaneous negative transfer should be stronger for novices than for experts. These predictions were supported by the results of three experiments involving college students solving a complex arithmetic word problem.     

Long-term memory in amnesia: cued recall, recognition memory, and confidence ratings

We explored what kind of information is acquired when amnesic patients are able to exhibit significant retention on tests of cued recall and recognition memory. Amnesic patients and control subjects attempted to learn sets of sentences. Memory for the last word in each sentence was tested after 1 hr in the case of the amnesic patients, or after 1 to 2 weeks in the case of (delayed) control subjects. Amnesic patients and (delayed) control subjects performed at similar levels on tests of cued recall and recognition memory. Amnesic patients were just as confident of their correct answers as were control subjects. However, amnesic patients were no more disadvantaged than control subjects when they were cued indirectly by presenting paraphrases of the original sentences. These findings demonstrate that the residual knowledge retained by amnesic patients can be as flexible, as accessible to indirect cues, and as available to awareness as the knowledge retained by (delayed) control subjects.     

A cost-benefit analysis of demand for food.

Laboratory studies of consumer demand theory require assumptions regarding the definition of price in the absence of a medium of exchange (money). In this study we test the proposition that the fundamental dimension of price is a cost-benefit ratio expressed as the effort expended per unit of food value consumed. Using rats as subjects, we tested the generality of this "unit price" concept by varying four dimensions of price: fixed-ratio schedule, number of food pellets per fixed-ratio completion, probability of reinforcement, and response lever weight or effort. Two levels of the last three factors were combined in a 2 x 2 x 2 design giving eight groups. Each group was studied under a series of six FR schedules. Using the nominal values of all factors to determine unit price, we found that grams of food consumed plotted as a function of unit price followed a single demand curve. Similarly, total work output (responses x effort) conformed to a single function when plotted in terms of unit price. These observations provided a template for interpreting the effects of biological factors, such as brain lesions or drugs, that might alter the cost-benefit ratio.     

Changes in functional response units with briefly delayed reinforcement

In two experiments, key-peck responding of pigeons was compared under variable-interval schedules that arranged immediate reinforcement and ones that arranged unsignaled delays of reinforcement. Responses during the nominal unsignaled delay periods had no effect on the reinforcer presentations. In Experiment 1, the unsignaled delays were studied using variable-interval schedules as baselines. Relative to the immediate reinforcement condition, 0.5-s unsignaled delays decreased the duration of the reinforced interresponse times and increased the overall frequency of short (<0.5-s) interresponse times. Longer, 5.0-s unsignaled delays increased the duration of the reinforced interresponse times and decreased the overall frequency of the short interresponse times. In Experiment 2, similar effects to those of Experiment 1 were obtained when the 0.5-s unsignaled delays were imposed upon a baseline schedule that explicitly arranged reinforcement of short interresponse times and therefore already generated a large number of short interresponse times. The results support earlier suggestions that the unsignaled 0.5-s delays change the functional response unit from a single key peck to a multiple key-peck unit. These findings are discussed in terms of the mechanisms by which contingencies control response structure in the absence of specific structural requirements.     

Discrimination learning in a foraging situation

Rats were allowed to forage in a simulated natural environment made up of eight food sources (patches) each containing a fixed number of pellets. Two of the eight contained an extra supply of peanuts. The peanut patches were signaled by an olfactory/visual cue located at the bottom of the ladder leading to the patch. In successive phases the number of sessions per day, height of the patches, and availability of peanuts were manipulated. Subjects showed evidence of discrimination learning under these conditions, although the degree of discriminatory behavior varied as a function of environmental manipulations. Assessment of behavior within foraging sessions showed that subjects systematically changed their patterns of utilization of patches across time. Sampling or exploration, as well as food reinforcement, seem implicated in these results.